Provider Demographics
NPI:1174092290
Name:AUDEN, MICHELLE ANNE (LICSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANNE
Last Name:AUDEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 5TH AVE
Mailing Address - Street 2:STE 500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 5TH AVE
Practice Address - Street 2:STE 500
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2810
Practice Address - Country:US
Practice Address - Phone:206-263-9105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW609157221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical